the art of liquid face lift (dermal fillers)
TRANSCRIPT
What to Inject?
FDA Approved Fillers
Prof. Moawad uses a variety of soft tissue fillers, including, hyaluronic acid, and
autologous fat (one's own fat) among other FDA approved fillers.
12/18/2009MSI Rejuvenation
5
Where to Inject?
Is My Results Permanent/Temporary
Temporary
6-M
Semi-permanent
6m-2years
Permanent
2-5years
Prof. Moawad believe
that volume
restoration of the
mid face is the first
essential step in the
global approach
Malar volume anchors the
structure of the midface
that will lessen the
appearance of the
nasolabial and the
nasojugal folds
Secondly, treatment of the
nasolabial folds and
periorbital area with HA
should be performed when
needed
Brow/Upper Eyelid / Temple Complex
TempleLateral eye brow Over time, loss
of subcutaneous fat, gravitational changes due to loss of elasticity, and remodeling of bony and cartilaginous structures lead to visible signs of aging.
Upper Eyebrow
Under eyes
Nasolabial
Lips
Brow/Upper Eyelid / Temple Complex
ABTemple
Brow/Upper Eyelid/Temple Complex
Upper Eyebrow
Under eyes
Nasolabial
Lips
The youthful brow/upper eyelid complex is characterized by soft tissue fullness.
AB
Temple
Under eyes
Middle
cheek
Temple, eyebrow and upper eye lid volume restoration is an emerging therapeutic area for
esthetic physicians
AB
Upper Eyebrow
Upper Eyelids
Hypertrophy is a visual, relative phenomenon. It is only in relationship to the flattened, inferior cheek mass that the suborbital area appears to protrude forward
Under Eyes Bags
Eye Bags
Nasolabial groove
B AA
AB
Infra-orbital and ant cheek fat Loss
AB
Infra-orbital and ant cheek fat Loss
AB
Reconstitution of the malar fat pads to re-establishes an aesthetic convex shape to the face that will lessen eye bags
Under eye bagsMiddle Cheeks Augmentation
AB
Reconstitution of the malar fat pads to re-establishes an aesthetic convex shape to the face that will lessen eye bags
AB
Reconstitution of the malar fat pads to re-establishes an aesthetic convex shape to the face that will lessen eye
bags
AB
AB
Reconstitution of the malar fat pads to re-establishes an aesthetic convex shape to the face
that will lessen eye bags
AB
Loss of under eyes
fat with hollow and
sunken appearance
together with
unmasking skin
blood vessels in
addition to the
shadowing effect of
concavity forces
patients often seek
treatment for under
eyes circles
Under Eyes Circles
Dark Circles
Reconstitution of the malar fat pads to re-establishes an aesthetic convex shape to the face that will lessen dark circles
AB
Dark Circles
Middle Cheek
AB
Reconstitution of the malar fat pads to re-establishes an aesthetic convex shape to the face that will lessen dark circles
Middle Cheek
Dark Circles
AB
Reconstitution of the malar fat pads to re-establishes an aesthetic convex shape to the face that will lessen dark circles
Volume restoration of infraorbital
will lessen dark circles
Atrophy of infraorbital pad of fat
AB
Under eyes dark circle
AB
AB
Dark Circles Infra orbital filling
AB
Eye BagsInfra orbital filling
AB
With senescence comes loss of the anterior projection of the cheek/ brow/forehead area, loss of the arcs, and a
downward displacement of tissue
AB
Under Eyes Bags
Reconstitution of the malar fat pads to re-establishes an aesthetic convex shape to the face that will lessen eye bags
AB
Reconstitution of the malar fat pads to re-establishes an aesthetic convex shape to the face that will lessen eye bags
AB
Removal of skin and
fat around the eye
alone during
blepharoplasty can
actually hollow the
eye and thereby age
the patient even
more dramatically
rather than serve to
rejuvenate
Post Blepharoplasty
ASunken Eyes
In both the
atrophic and
hypertrophic
variants of
suborbital
aging, filling is
an excellent tool
to restore the
normal arced
contour of the
eye/cheek
complex
B
Patient who ages by a diffuse loss of facial fat without any apparent residual skin is an ideal candidate
AB
The primary patient who ages by a diffuse loss of facial fat without any apparent residual skin is an
ideal candidate.
AB
Dermal Fillers are being used in Lieu of Structural fat grafts to add volume to the aging face
AB
B A
NasolabialB
A
Nasolabial
Marionette line
B
A
B
Prejowl sulcus
AB
Chin Augmentation
B
Nasolabial
A
AB
B AA
B A
B A
B A
B
Prejowl sulcus
A
B A
B A
Reconstitution of the malar fat pads to re-establishes an aesthetic convex shape to the face that will lessen nasolabial and marionette lines
AB
B A
AB
Marionette line
B
AB
AB
B A
Loss of ant, lat and buccal fat
AB
Buccal Recess
B
A
Buccal Recess
B
A
B A
A
Buccal Recess
B
AB
B A
Submalar Hollow
AB
Submalar Hollow
AB
Nonsurgical rhinoplasty (NSR) using an injectable dermal filler has gained popularity for both primary and revision
nose enhancement procedures
Soft tissue filler injections can provide an immediately visible result in the convenience of the office setting
Despite its temporary
longevity, it is popular
because it is simple,
effective, and
economical
Non Surgical
Nose Job
Nasal Tip
Small Defects
Saddle dorsum
Nasion
Nasal deviation
Where to Inject in the Nose?
Non Surgical Nose Job
AB
Non Surgical Nose Job
AB
B
Non Surgical Nose Job
A
B A
Non Surgical Nose Job
B A
Non Surgical Nose Job
AB
Non Surgical Nose Job
B A
Non Surgical Nose Job
B A
Non Surgical Nose Job
B A
Non Surgical Nose Job
A
Non Surgical Nose Job
B
B A
Non Surgical Nose Job
AB
Acne Scars
B
AB
AB
AB
B
A
B
A
B
A
B
A
A
B A
B
A
Shaping the lips, not just adding volume
B
Shaping the lips, not just adding volume
A
B
Shaping the lips, not just adding volume
A
A
Shaping the lips, not just adding volume
B
Shaping the lips, not just adding volume
A
B
Shaping the lips, not just adding volume
A
B
Shaping the lips, not just adding volume
A
B
Shaping the lips, not just adding volume
A
AB
Shaping the lips, not just adding volume
AB
Shaping the lips, not just adding volume
B
A
Shaping the lips, not just adding volume
B A
Shaping the lips, not just adding volume
AB
Shaping the lips, not just adding volume
Soft tissue fillers are
often considered the
first line in the
treatment of aging
skin and are
frequently used in
combinations or
with other
techniques for facial
rejuvenation
Complementary Procedures
Complementary Procedures
Subcision is done before filling
A.Subcision Surgery
AB
Botox injection before dermal filler willimprove the results of both and keep it longer
B. Botox
B. Botox
Botox injection before dermal filler willimprove the results of both and keep it longer
Pitfalls of FillersDiscomfort
Bruising
Swelling
Bluish Discoloration
Asymmetry
Beading
Infection
What Do I
Expect
Immediately
after
Injections?
Early and expected side
effects include swelling,
bruising, and redness at
the injection
Redness
Swelling
Bruising
when an undesirable outcome occurs with hyaluronic acid, correction is possible with the injection of commercially available hyaluronidase, which breaks down the unwanted hyaluronic acid dermal filler
What If Something Goes Wrong?
A.Resorable Fillers
What If Something Goes Wrong?
B. Permanent Fillers
Complications secondary to biodegradable or resorbablefillers will disappear spontaneously in a few months, but non-resorbable fillers may give rise to severe permanent reactions. Patient are left helpless. These permanent products should be reserved to reconstructive surgery
Immediate Icing and Massage to
decrease swelling and bruising
fillers can be injected into the skin to improve the appearance of fine lines and wrinkles, plump lips, fill hollow cheeks, repair various facial imperfections, improve scars, and elevate deep folds
Since filler substances do not involve major surgery and are generally cost-effective, men and women are using these youth-enhancing techniques more than ever.
The use of
injectable
products for
cosmetic
enhancement is
increasing rapidly.
This is due in large
part to the wide
range of effective
options, decrease
in social stigma,
and the excellent
safety profile.